new member application

Step 1 of 3

  • This will be the username that you will use to log in.
  • MANDATORY - All communication is done through e-mail
  • MM slash DD slash YYYY

Membership Requirements

  1. Applicant must be over 25 years of age.
  2. Applicants must be referred by a member in good standing.
  3. Copy of professional license.
  4. Applicant must live or work in New York State.
  5. Fully completed application, including e-mail address.
  6. Never have been convicted of a felony.

Membership Rules

  1. Credentials are property of the Lodge.
  2. Upon disengagement all credentials must be returned.
  3. Annual dues are due in July of the preceding year. Administrative fees are added for delinquent payments.
  4. Any misuse of credentials will result in termination of membership.


  • Application Fee and Initiation Fee (One Time): $250
  • Annual Dues: $250

Total Payment Due (with application): $500

If paying by check please make check payable to:
NYSFOP Surgeons Lodge SA03

Mail to:
NYS Fraternal Order of Police SA03
P.O. Box 100
Bridgehampton, NY 11932

Administrative fees:

  • Dues paid after September 30th of the billing cycle will incur a $50 administration fee.
  • Dues paid after December 31st of the billing cycle will incur a $100 administration fee.

The FOP provides a $10,000 Accidental Death insurance policy to all members as a benefit. Please provide the name of a Beneficiary.

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upcoming events


New York State Fraternal Order of Police Surgeons & Associates Lodge Store items are available to members only.